Acid-base and bio-energetics during balanced versus unbalanced normovolaemic haemodilution

Morgan, TJ, Venkatesh, B, Beindorf, A, Andrew, I and Hall, J (2007) Acid-base and bio-energetics during balanced versus unbalanced normovolaemic haemodilution. Anaesthesia And Intensive Care, 35 2: 173-179.

Author Morgan, TJ
Venkatesh, B
Beindorf, A
Andrew, I
Hall, J
Title Acid-base and bio-energetics during balanced versus unbalanced normovolaemic haemodilution
Journal name Anaesthesia And Intensive Care   Check publisher's open access policy
ISSN 0310-057X
Publication date 2007
Sub-type Article (original research)
Volume 35
Issue 2
Start page 173
End page 179
Total pages 7
Place of publication Edgecliff
Publisher Australian Soc Anaesthetists
Collection year 2008
Language eng
Subject C1
Abstract Fluids balanced to avoid acid-base disturbances may be preferable to saline, which causes metabolic acidosis in high volume. We evaluated acid-base and bio-energetic effects of haemodilution with a crystalloid balanced on physical chemical principles, versus crystalloids causing metabolic acidosis or metabolic alkalosis. Anaesthetised, mechanically ventilated Sprague-Dawley rats (n=32, allocated to four groups) underwent six exchanges of 9 ml crystalloids for 3 ml/blood. Exchange was with one of three crystalloids with strong ion difference (SID) values of 0, 24 (balanced) and 40 mEq/l. Controls did not undergo haemodilution. Mean haemoglobin concentration fell 11 to approximately 50 g/l after haemodilution. With SID 24 mEq/l fluid, metabolic acid-base remained unchanged. Dilution with SID 0 mEq/l and 40 mEq/l fluids caused a progressive metabolic acidosis and alkalosis respectively. Standard base excess (SBE) and haemoglobin concentration were directly con-elated in the SID 0 mEq/l group (R-2 = 0.61), indirectly correlated in the SBE 40 mEq/1 group (R-2 = 0.48) and showed no correlation in the SID 24 mEq/l group (R-2=0.003). There were no significant differences between final ileal values of CO2 gap, nucleotides concentration, energy charge, or luminal lactate concentration. SID 40 mEq/l crystalloid dilution caused a significant rise in subcutaneous lactate. In this group mean kidney ATP concentration was significantly less than controls and renal energy charge significantly lower than SID 0 mEq/l and control groups. We conclude that a crystalloid SID of 24 mEq/l provides balanced haemodilution. Bio-eneigetic perturbations with higher SID haemodilution may be more severe and need further investigation.
Keyword Anesthesiology
Critical Care Medicine
balanced crystalloid
strong ion difference
Lactated Ringers Solution
Hyperchloremic Acidosis
Cardiopulmonary Bypass
Respiratory Alkalosis
Crystalloid Solutions
Fluid Resuscitation
Experimental Sepsis
0.9-percent Saline
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Mon, 18 Feb 2008, 17:04:14 EST